Provider Demographics
NPI:1861686917
Name:BEHL, JYOTI (MD)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:
Last Name:BEHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 LUPIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5023
Mailing Address - Country:US
Mailing Address - Phone:713-855-5547
Mailing Address - Fax:
Practice Address - Street 1:547 LUPIN ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-5023
Practice Address - Country:US
Practice Address - Phone:713-855-5547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100246207Q00000X
TXM7852207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188733301Medicaid
TXM7852OtherLICENSE
TX8AN550OtherBCBSTX
TX8K0527Medicare PIN